Which of the following injections is routinely administered to a newborn to prevent bleeding?

Appeared in: AIIMS Bhopal NO - 2018 (Shift-1st)

Explanation

Newborns are physiologically deficient in vitamin K due to limited transfer across the placenta and a sterile gut that cannot yet synthesize it.
Vitamin K is a crucial co-factor for the synthesis of clotting factors II, VII, IX, and X in the liver.
Prophylactic administration of vitamin K prevents Vitamin K Deficiency Bleeding (VKDB), a condition that can cause severe internal or external hemorrhage.
The standard of care is a single intramuscular injection of 0.5 to 1 mg of vitamin K (phytonadione) shortly after birth.

Option A: Calcium gluconate is used to correct hypocalcemia (low blood calcium), not to prevent bleeding.
Option C: Sodium bicarbonate (soda bicarbonate) is an alkalinizing agent used to treat severe metabolic acidosis.
Option D: Methylergometrine is a potent uterotonic agent administered to the mother, not the newborn.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Neonatal Prophylaxis as background academic context rather than a clinical decision trigger.
A nurse's primary responsibility includes administering the vitamin K injection correctly, typically into the vastus lateralis muscle, and documenting it accurately.
Patient education is crucial. Nurses must be prepared to explain the risks of refusing the injection (severe, potentially fatal bleeding) versus the minimal risks of the injection itself to parents who may have concerns.
What if parents refuse the injection due to misinformation? The nurse should first provide clear, evidence-based information about the safety and life-saving importance of vitamin K. If they still refuse, the nurse must document the refusal thoroughly, ensure the parents sign a refusal form, and notify the pediatrician, as the infant is now at higher risk for VKDB.

How to Approach the Question

First, identify the core of the question: it asks for a routine injection given to a newborn specifically to prevent bleeding.
Recall the standard prophylactic medications administered to all newborns immediately after birth. The main ones are vitamin K injection, antibiotic eye ointment, and the first dose of the Hepatitis B vaccine.
Evaluate each option based on its known pharmacological action and indication in neonates.
Eliminate 'Calcium gluconate' as it's for low calcium, not bleeding.
Eliminate 'Soda bicarbonate' as it's for acidosis.
Eliminate 'Methylergometrin' as it's a drug for the mother (to prevent postpartum hemorrhage), not the baby.

Concept Tested & Keywords

Q4lflg34w1ZWzZMDIn7TF9

E6 Nelson Textbook of Pediatrics(2024) — Volume 1 p. 1138-1140

E6 Obstetrics Williams p. 16-33

Practise the full AIIMS Bhopal NO - 2018 (Shift-1st)

Attempt every question from this paper in a timed mock, then review the full solution for each one.